Kornimate/medical-research-clean huggingface dataset:
the incidence of undiagnosed osa compared in multi-ethic races of malaysia & the associated postoperative complications

Conditions: Obstructive Sleep Apnea

Summary: obstructive sleep apnoea (osa) is a condition in which a person's sleep is disrupted with momentary periods of apnoea and hypopnoea. this occurs when there is a blockage to airflow. when this happens, the patient will snore, gasp or choke in the attempt to attain more oxygen. this results in disrupted sleep and the patient may even awake from sleep. it has been found that a great proportion of malaysians have habitual snoring and with the increase in obesity over the years, it is a concern that osa may be prevalent in malaysia. however, it has been seen that osa is commonly undiagnosed in patient. this poses a worry because these people can come in for surgery. diagnosis of osa before surgery is important in order to prepare for the complication related to osa.

research staff will interview and examine patients and review their charts to obtain information on patient characteristics. patients will also be assessed using stop-bang questionnaire \& epworth sleepiness scale. anaesthesia and surgery will be performed according to routine standard of care. drugs used during anaesthesia, postoperative analgesia and hemodynamic data will be recorded. during their stay in hospital, patients will be followed daily, and outcomes will be recorded, until discharge. data on medications will be recorded.

Eligibility criteria:
inclusion criteria: * adult males and females * age ≥ 18 years * undergoing elective surgery ( general,regional or local anaesthesia with monitored anaesthesia care) exclusion criteria: * previous diagnosis of osa or any sleep-related breathing disorder * they are unwilling * their surgery included tonsillectomy, septoplasty, uvloplasty, pharyngoplasty, tracheostomy, or prolonged mechanical ventilation

Keywords: osa obstructive sleep apnea operation
early silent graft failure in off-pump coronary artery bypass grafting: a computed tomography analysis

Conditions: Coronary Artery Disease; Bypass Complication; Graft Failure

Summary: aortocoronary bypass surgery is one of the most common operations in the western world. the goal of the surgeon is to perform a complete revascularization of the coronary arteries with the best, available bypass material. aortocoronary bypass surgery can be performed with (on-pump) or without (off-pump) the heart lung machine. if the operation is performed without the heart lung machine, the heart is continuously beating while the surgeon sews the bypass to the diseased coronary artery. in randomized trials, the benefits of the off-pump technique in the hands of experienced surgeons in terms of shorter operating times, less transfusions and less pulmonary and renal complications were proven. a criticism of the off-pump technique is the reduced number of distal anastomoses, which means that fewer coronary arteries may be connected with bypass grafts because of the technically sophisticated situation. a worse quality of the connection (anastomosis) between coronary artery and bypass is often discussed, leading to a bypass occlusion already in the early stage after surgery resulting in more re-interventions on the coronary vessels. so-called silent bypass failure without clinical correlation has been examined in three relevant studies including both, the on- and the off-pump technique, with inhomogenous results. in addition to the technique, other parameters such as the degree of narrowing (stenosis) of the diseased coronary artery and collateralization of a closed coronary artery may play a role in early occlusion. all bypass patients after off-pump surgery receive routinely a computed tomographic examination of the heart. with this method, silent bypass occlusions without clinical correlation, i.e. cardiac infarction, elevated cardiac laboratory parameters or ecg changes, can be detected easily. in case of an occlusion of a relevant bypass, an intervention before discharge can be planned and performed. we would like to investigate the occlusion rate of this retrospective patient cohort after off-pump surgery and the potential risk factors, that may influence on early graft failure. we hypothesize, that early graft failure depends not only on the choice of the graft material, but also on the local grade of coronary stenosis, the collateralisation of occluded coronary vessels and the intraoperative flow results, as well as on the region of the target vessel.


Eligibility criteria:
inclusion criteria: * patients after off-pump coronary artery bypass grafting * postoperative computed tomography for the evaluation of the bypass patency before discharge exclusion criteria: * operation with a heart-lung machine * combined interventions * postoperative emergency coronary angiography * there is a documented rejection
haldol/diphenhydramine versus metoclopramide/diphenhydramine for treatment of acute headache in the emergency department: a randomized controlled trial

Conditions: Migraine Headaches; Nausea; Restlessness

Summary: haloperidol is known to be a safe alternative medication to control difficult pain, and has been shown effective when compared to placebo for controlling headaches. investigators hypothesized that the combination of haloperidol and diphenhydramine would be a useful medication choice for migraine headache patients in the emergency department in comparison to a common migraine treatment regimen of metoclopramide and diphenhydramine.

investigators conducted a prospective, double-blind, randomized controlled trial in migraine patients who presented to an academic emergency department between june 2013 and november 2013. research data was derived from an irb approved protocol. all subjects met ihs migraine criteria and received a one liter bolus of normal saline plus 25 milligrams (mg) of diphenhydramine. subjects were subsequently randomized to receive 10 mg metoclopramide or 5 mg haloperidol iv. pain was self-reported at onset and at 20 minute intervals using a 100mm visual analog scale (vas). adequate pain control was considered to be patient satisfaction with symptomatic relief. if adequate pain relief was not obtained after 80 minutes, rescue medication was given at the treating physician's discretion. adverse reactions were recorded and electrocardiograms (ecgs) were obtained before and after study medication administration. follow up phone surveys were performed 72 hours after discharge to assess headache recurrence, adverse effects, and patient satisfaction.

Eligibility criteria:
inclusion criteria: migraine headache must contain the following: * at least two: unilateral, throbbing, worsening with activity, moderate to severe pain * at least one: nausea or vomiting, photophobia or phonophobia * ages 18-50 exclusion criteria: * hypersensitivity to haloperidol, metoclopramide, and/or diphenydramine * history of ischemic heart disease or signs or symptoms of ischemic heart disease * history of stroke or transient ischemic attack (tia) * history of peripheral vascular disease * history of uncontrolled hypertension with presenting diastolic blood pressure \> 100 * use of an ergotamine derivatives, triptan, or dopamine-blocking anti-emetic within the past 24 hrs * concurrent administration or within 2 weeks of discontinuing an mao inhibitor * concurrent management of hemiplegic or basilar migraine or known neurologic disorder * severe hepatic impairment * pregnancy or breastfeeding * history of cancer (except non-melanoma skin cancer) * previous involvement in the study * febrile to 100.5 or greater * any indication for further diagnostic evaluation of this headache such as a lumbar puncture or ct scan. * headache differs from their normal headache
glycemic profile in women with gestational diabetes treated with glyburide

Conditions: Gestational Diabetes

Summary: diabetes is more likely to occur during pregnancy. when present only in pregnancy it is called gestational diabetes, and it places both mom and baby at risk for complications. glyburide is one of the currently used treatments for diabetes during pregnancy. this drug is a medication taken by mouth that decreases sugar levels in the blood. it is known to decrease the risk of complications linked to diabetes in pregnancy. recent studies in pregnancy have described a difference in the way and how well the drug works compared to when used outside of pregnancy. oral blood sugar lowering agents are approved by the food and drug administration (fda) to lower blood sugar in non-pregnant subjects with diabetes. no oral (taken by mouth) blood-sugar lowering agents are fda approved for use in pregnancy. although glyburide is not fda approved for this use, it is the most commonly used oral blood sugar lowering agent in pregnancy. this research study will help us learn more about the variations in blood sugar levels in women with diabetes in pregnancy who are taking glyburide and how changes in the timing of when the glyburide is taken would affect blood glucose levels. the goals of this study are: * to find the how glucose changes throughout the day in women with diabetes in pregnancy receiving glyburide * to learn the effect of changing the time of taking glyburide on glucose levels * to learn the effect of changing the time between glyburide doses on glucose levels * to see if insulin is secreted the same throughout the day in response to a morning dose of glyburide.


Eligibility criteria:
inclusion criteria: * pregnant women with gestational diabetes * singleton gestation * receiving glyburide for the treatment gestational diabetes * able to give consent exclusion criteria: * women who require insulin for the treatment of gestational diabetes * diagnosis of pregestational diabetes * poor glycemic control, \> 50% of blood glucose values over 200mg/dl prior to start of the study * women receiving medications that affect glycemic control e.g. steroids, within a week of enrollment.
study to characterise patients receiving benralizumab in the framework of an individualized access program in spain

Conditions: Severe Eosinophilic Asthma

Summary: observational, retrospective study in adults (≥18 years) with severe asthma (maintenance treatment with high dose inhaled corticosteroids combined with long-acting agonist β2) and eosinophilic phenotype, who at the discretion of the investigator were candidates to receive benralizumab in the individualized access program approved by national health authorities. primary objective: to describe the demographic and baseline characteristics in patients with severe eosinophilic asthma who participated in the individualized access program approved in spain and received at least one dose of benralizumab. secondary objectives: to describe clinical outcomes in severe eosinophilic asthma patients who received at least three doses of benralizumab in the individualized access program.


Eligibility criteria:
inclusion criteria: * adult patients (age ≥18 years) * diagnosis of severe eosinophilic asthma requiring stable treatment of high doses of inhaled corticosteroids and a long-acting agonist β2 ± additional asthma controller * received at least one dose of benralizumab during the individualized access program period (march-december of 2018) * informed consent signed exclusion criteria: * patients enrolled in a clinical trial who received benralizumab during the same period of the individualized access program * refuse to sign the informed consent
driving in mild dementia decision tool

Conditions: Dementia

Summary: based on the literature on dementia and driving, and on knowledge tools available to date including one from our current work, a driving in mild dementia decision tool (dmd-dt) will be adapted and tailored to guide physicians in their decisions to report a driver with mild dementia to the provincial licensing agency. the dmd-dt intervention will include a) an algorithm-based computerized clinical decision support system (ccdss) for facilitating driving assessment and physicians' reporting to provincial transportation authorities, b) an individualized educational package for patients and caregivers about dementia and driving and driving cessation, and c) a modified reporting form to provincial driving regulatory authorities. months 1 to 6: the dmd-dt will be tailored and adapted to practice with the input of the co-investigators and knowledge-users who represent the perspectives of physicians, patients and their caregivers, as well as transportation authorities. pilot testing will be done, and input from focus groups of knowledge-users will refine the intervention. physicians will be recruited to participate in a clinical trial of the dmd-dt. months 7-18: a parallel-group cluster randomized controlled trial (rct) will be conducted to compare the effects of the dmd-dt to a legislation reminder on recommendations for reporting to the licensing agency. the effects of the dmd-dt on the doctor-patient relationship will be further explored in focus groups and interviews with physicians. months 19-24: the knowledge obtained from the study will be used to generalize and sustain use of the intervention beyond ontario, canada, and to disseminate the information to knowledge-users. the primary outcome measure is the filing of a report to the ministry of transportation of ontario, indicating that the physician has a concern about the patient's health condition (i.e. mild dementia). the primary outcome of the study is the difference in reporting between the dmd-dt and control arms. since the current reporting rate is low, approximately 13%, from a public health point of view, the primary outcome expected is that physicians in the dmd-dt group will report more patients with mild dementia than those in the control group.

as above

Eligibility criteria:
inclusion criteria: * family physicians and specialist physicians (geriatricians, geriatric psychiatrists, cognitive neurologists) practicing in ontario, canada, who assess and treat patients with mild dementia * must speak english and have computer access at the point of delivery of care exclusion criteria: * family physicians must see at least 10 new patients per year with mild dementia, and specialist physicians must see at least 12 new patients per year with mild dementia * participants must not have participated in, attended a continuing medical education (cme) event about, or read about our "dementia and driving in ontario" study (2010-2012)

Keywords: dementia automobile driving accidents, traffic
pulsed radiofrequency for emotional stress

Conditions: Chronic Pain

Summary: the objective of the study is to assess the short-term and long-term effects of transcutaneous pulsed radio frequency treatment on the physiological status, subjective well-being, and on the intensity of pain. category a transcutaneous pulsed radiofrequency is a method that is widely used for control of pain. there are no known complications. in this study a radiofrequency generator will be used that has a separate outlet for transcutaneous use. patients will be recruited within the clinic population of patients.

data will be assessed in at three times, the baseline testing, the first and the second follow-up meeting (+2-4 days of intervention; as well as + 40 days via post/email) the inclusion criteria are: inclusion: * age 18 - 65 * chronic pain (duration of three months or more) patients of the pain center nottwil, swiss paraplegic center the following criteria will lead to an exclusion of the study: * severe medical issues, such as cancer or comparable diseases * severe mental disorders such as severe depression or schizophrenia * patients with pacemakers or with atrial fibrillation * women who are pregnant or breast-feeding the primary outcome assessed is the physiological status, assessed by the heart rate variability (hrv). secondary outcomes are the subjective well-being, as assessed by the "marburger questionnaire regarding habitual well-being" (fw-7) questionnaire as well as the intensity of pain, as assessed by the numeric rating scale for pain intensity (nrs) score and by a 7-point likert scale.

Eligibility criteria:
inclusion criteria: * age 18 - 65 * chronic pain (duration of three months or more) patients of the pain center, swiss paraplegic center, nottwil exclusion criteria: * severe medical issues, such as cancer or comparable diseases * severe mental disorders such as severe depression or schizophrenia * patients with pacemakers or with atrial fibrillation * women who are pregnant or breast-feeding
the consciousness variation of deep brain and transcranial magnetic stimulation for disorders of consciousness patients

Conditions: Consciousness Disorders

Summary: aims:to explore the consciousness stimulation role of dbs (deep brain stimulation) and tms (transcranial magnetic simulation) for doc (disorders of consciousness) patients. methods:seventy-five doc patients will be randomised into three groups: dbs group, tms group and control group. three months after treatments, the result will be analysed and concluded.

to explore the consciousness stimulation role of dbs (deep brain stimulation) and tms (transcranial magnetic stimulation) for doc (disorders of consciousness) patients. seventy-five doc patients will be randomised into three groups: dbs group, tms group and control group. these patients will be recorded the conscious level, fmri (functional magnetic resonance imaging) and eeg evaluation before treatment of research, and three months later the prognosis was also recorded. finally, the variation of consciousness, prognosis, fmri and eeg index for three groups will be analyzed and compared. hopefully, there will be a conclusion for these treatments to doc patients.

Eligibility criteria:
inclusion criteria: 1. patients ages 14 to 65 years old; 2. doc patients, including vegetative state and minimally consciousness state. 3. with normal body temperature, stable vital signs, spontaneous breathing without extra oxygen supply, no tracheotomy using metal trachea cannula, and feasible for magnetic resonance inspectors; 4. written informed consent from patient families exclusion criteria: 1. history with nervous or spirit disorders, or some other serious diseases such as cardiac or pulmonary problems; 2. patients with v-p shunt or ommaya implantation, which may effects magnetic resonance scan signal analysis; 3. body temperature is abnormal, vital signs is not stable, still need ventilator to support breathing; plentiful sputum needed suction during mri scans.

Keywords: disorders of consciousness deep brain stimulation transcranial magnetic stimulation
a study to compare the efficacy, safety, pharmacokinetics, and immunogenicity between sb27 and keytruda in subjects with metastatic non-squamous non-small cell lung cancer

Conditions: Non-small Cell Lung Cancer Stage IV

Summary: the goal of this clinical trial is to confirm that sb27 works in the same way as keytruda in metastatic non-squamous non-small cell lung cancer (nsclc) patients. the main question it aims to answer is: • how effective the study drug is participants will receive either investigational product (sb27 or keytruda) and chemotherapy every 3 weeks. researchers will compare sb27 and keytruda to see if sb27 works in the same way as keytruda.


Eligibility criteria:
inclusion criteria: * male or female ≥ 18 years of age * have been diagnosed with stage iv non-squamous nsclc * have not received any prior systemic anti-cancer therapy for metastatic nsclc * agree to use adequate methods of contraception exclusion criteria: * unable or unwilling to take folic acid and vitamin b12 supplementation * severe hypersensitivity to treatment with another monoclonal antibody, any ingredient contained in sb27 or keytruda, or any component of platinum-containing compounds or pemetrexed.
surgical treatment of complex regional pain syndrome type ii (crps ii)

Conditions: CRPS Type II

Summary: the purpose of this study is to investigated and evaluated the effectiveness of a new surgical technique for the treatment of severe chronic pain stages (complex regional pain syndrome type ii).

for 140 years the treatment of complex regional pain syndromes type ii (crps ii) has been an unsolved problem. recent findings in animal models assume that crps type ii is maintained by a coupling of newly sprouted sympathetic and sensible fibres. therapeutic approaches have included conventional pain medication, physical therapy, sympathetic blocks, transcutaneous or spinal cord stimulation, injections or infusion therapies and sympathectomy. alone or in combination these therapies often yielded unfavorable results. the majority of physicians dealing with crps patients are convinced that a surgical treatment of the affected extremity only exacerbates the symptoms, especially its hallmark excruciating pain. patients with a crps type ii at the upper or the lower limb will be included in the study after ineffective pain therapy for more than 6 months. the most proximal region of pain associated with crps can be localized and 2% lidocain will be injected into that area. if the sympathetic, deep, burning pain can be blocked repeatedly with these injections, the subcutaneous veins in the previously determined area will be surgically removed. this operation should lead to the permanent resolution of symptoms. a visual analogue scale (vas), the nottingham health profile (nhp), thermography and physical examinations will be used to evaluate the outcome of the operation.

Eligibility criteria:
inclusion criteria: * patients suffering from crps type ii after after ineffective pain therapy for more than 6 months. exclusion criteria: * ineffective testinfiltration with an local anesthetic pregnancy

Keywords: crps type ii pain surgery regional subcutaneous venous sympathectomy(rsvs) sudeck reflex sympathetic dystrophy (rsd) causalgia algodystrophy